• Clinical and Experimental Reproductive Medicine
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• 제49권3호
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• pp.210-214
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• 2022

Objective: Platelet-rich plasma (PRP) therapy has received a considerable attention as an adjunct to fertility treatments, especially in women with very low ovarian reserve and premature ovarian insufficiency. Although recent studies have demonstrated that PRP led to improvements in folliculogenesis and biomarkers of ovarian reserve, the effect of intraovarian PRP administration on embryo genetics has not been studied. Methods: We report a pilot study of patients who had preimplantation genetic testing for aneuploidy (PGT-A) before and then within 3 months following PRP administration. Twelve infertile women with at least one prior failed in vitro fertilization (IVF) cycle underwent ovarian stimulation (cycle 1) with a gentle stimulation protocol and PGT-A performed at the blastocyst stage. Following cycle 1, autologous intraovarian PRP administration was performed. Within 3 months following PRP administration, the patients underwent cycle 2 and produced blastocysts for PGT-A. The percentage of euploid embryos between both cycles was compared. Results: The mean age of all participants was 40.08±1.46 years, and their mean body mass index was 26.18±1.18 kg/m². The number of good-quality embryos formed at the blastocyst stage was similar between cycle 1 and cycle 2 (3.08±0.88 vs. 2.17±0.49, respectively; p=0.11). Among all patients in cycle 1, 3 of 37 embryos were euploid (8.11%) while in cycle 2, 11 out of 28 embryos were euploid (39.28%, p=0.002). Three clinical pregnancies were noted among this patient group. Conclusion: This novel study is the first to present an improvement in the embryo euploidy rate following intraovarian PRP application in infertile women with prior failed IVF cycles. The growth factors present in PRP may exhibit a local paracrine effect that could improve meiotic aberrations in human oocytes and thus improve euploidy rates. Whether PRP improves live birth rates and lowers miscarriage rates remains to be determined in large trials.

• 한국수정란이식학회:학술대회논문집
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• 한국수정란이식학회 2002년도 국제심포지엄
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• pp.112-112
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• 2002

Under normal conditions, women produce a single dominant follicle that participates in a single ovuation each menstrual cycle. But Polycystic ovary syndrome(PCOS) conditions, folliculogenesis does not proceed normally. This condition leads to the accumlation of large numbers of small graffian follicles in which the theca interstitial cells (TIC) produce abnormally large amounts of androgen. PCOS is probably the most common endocrine disorder, affecting women of reprodutive age with 5-10% prevalence estimate. Chronic anovulation, hyperandrogenism, hirsutism, obesity, infertility and polycystic ovaries are clinical hallmarks of women with PCOS. Its etiology remains unknown. To investigate the gene expression pattern of ovary in PCO-induced rat, we used cDNA expression analysis. Total RNA was extracted from the ovary of PCO-induced rat and reverse-transcribed in the presence of［$\alpha$$^{32}$P］-dATP Which were hybridized to Atlas$^{TM}$ Rat Toxicology 1.2 array (Clontech) representing approximately 1176 rat genes. We compared gene expression between ovary of pco-induced immature female rats and control. Differential gene expression profiles were revealed (LIFR-alpha, ADRA1A, Heat shock 90-kDa protein A, PDGFRA). Reverse transcription-polymerase chain reaction(RT-PCR) was used to validate the relative expression pattern obtained by the cDNA array. The precise relationship between the altered expression of genes and PCO is a matter of further investigation. This study was supported by Korea Science and Engineering Foundation(KOSEF)

• Clinical and Experimental Reproductive Medicine
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• 제50권4호
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• pp.285-291
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• 2023

Objective: Infertility can result from a diminished ovarian reserve, but a potential remedy exists in the form of platelet-rich plasma (PRP) administration. This treatment involves both biological factors and tissue trauma mechanisms, which stimulate folliculogenesis, making it a promising and effective strategy. We assessed the impact of direct PRP injections into the ovaries on the fertility outcomes of women classified as poor responders. Methods: A quasi-experimental study was conducted from April 2021 to December 2022, focusing on patients classified as POSEIDON grade 3 or 4. PRP injections were administered into both ovaries. After 3 months, data were collected on anti-Mullerian hormone (AMH) level, follicle-stimulating hormone (FSH) level, and the numbers of oocytes, mature oocytes, and good-quality embryos following ovarian stimulation. We then compared the data from before and after PRP injection. Results: This study included 50 women, with a mean of 39 years (interquartile range [IQR], 35 to 43) and 4 years (IQR, 2 to 6) for age and infertility duration, respectively. FSH levels decreased after treatment, while AMH levels and the numbers of oocytes, metaphase II oocytes, and high-quality embryos increased. However, only the increase in high-quality embryos was significant. The pregnancy and spontaneous pregnancy rates were 20% and 14%, respectively. Notably, women with secondary infertility exhibited a significantly higher pregnancy rate than those with primary infertility. Conclusion: Ample evidence suggests that PRP can enhance ovarian function. However, further studies are needed to identify the appropriate candidates for this procedure, establish the optimal PRP preparation method, and standardize the procedure for its adjuvant use in assisted reproductive technology cycles.

• 대한임상검사과학회지
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• 제48권1호
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• pp.8-14
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• 2016

포유류의 난소에서 과립막 세포)는 난포내 난자를 둘러싸고 난자 뿐만 아니라 난포의 발달에 필요한 상태를 만드는데 중요한 역할을 한다, 그리고 협막세포 등의 성장과 분화를 조절하는 매우 복잡한 과정이다. 본 연구의 목적은 성장이 정지되어 있는 원시난포에서 성장이 개시되는 1차난포, 2차난포로 전환하는 동안에 관여하여 발현하는 유전자를 조사하는 것이다. 본 연구에서는 5일자, 12일자 난소로부터 총 리보핵산을 추출하여 동량의 RNA로부터 cDNA를 합성하여 ACP-PCR을 수행하였다. 서로 다르게 발현하는 유전자들 (DEGs)을 클로닝과 BLAST를 통한 염기서열 분석하였다. Anxa11과 Plekha5는 5일자 난소에서 높게 나타났으며 특히 난자핵과 세포질에서 높게 발현하였다. 이에 반해 과립막 세포에서는 난포발달단계에 따라 증가하는 양상을 보였다. 본 연구에서 성공적으로 5일, 12일 난소에서 서로 다르게 발현하는 발현유전자 목록을 일부 찾아 확인하였다. 이들은 막융합을 통해 난소의 난포발달과정에서 시간적-공간적인 조절 기전에 의해 이루어 질 것으로 보인다. 이 유전자 발현 정보는 원시난포의 개시와 성장을 위한 전환에 관여하는 기전을 이해하는 기초정보와 난소기능부전의 기전을 규명하는데 정보를 제공할 것으로 기대된다.

• 한국발생생물학회지:발생과생식
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• 제14권2호
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• pp.91-97
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• 2010

FOXL2는 winged-helix/forkhead(FH) 도메인 전사인자로서 FOXL2 유전자에 돌연변이가 발생할 경우 blepharophimosis-ptosis-epicanthus inversus syndrome이라 불리는 BPES 질병이 유발되게 된다. BPES는 상염색체 우성인 유전적 질환이다. BPES type I의 환자는 조기난소부전증(POF)과 안검하수 증상이 함께 나타나는 반면, BPES type II의 경우 안검하수 및 소안검 등 안면기형만이 유발된다. FOXL2 단백질이 결여된 난소에서 granulosa 세포의 분화가 멈추는 것으로 보아 FOXL2가 정상적인 난소의 folliculogenesis에 필수적인 역할을 하고 있음을 시사한다. 이전의 연구 결과에서, 본 연구진은 FOXL2와 상호작용하는 단백질에 대한 스크리닝을 통해 스테로이드 합성효소인 CYP19 전사활성에 영향을 미치는 steroidogenic factor-1(SF-1)을 동정하였다. 이번 연구를 통해 FOXL2가 CYP19의 전사를 향상시키고, SF-1에 의한 CYP19의 전사를 더욱 촉진시킨다는 것을 증명하였다. 이와 반대로, BPES 타입 I과 II에서 발견된 FOXL2의 돌연변이형들은 SF-1에 의해 증가된 CYP19의 전사활성을 향상시키는 능력이 감소함을 보여주었다. 본 실험을 통해 FOXL2 돌연변이에 의해 유발되어지는 BPES 질환의 병리생리학적인 이해에 대해 도움을 줄 수 있는 FOXL2의 야생형과 돌연변이형 사이의 서로 다른 기능적인 차이점을 규명하였다.

• Clinical and Experimental Reproductive Medicine
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• 제16권1호
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• pp.69-79
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• 1989

Steroid hormone profiles during luteal phase of clomiphene citrate(CC)/human menopausal gonadotropin(hMG)/human chorionic gonadotropin(hCG)-stimulated in vitro fertilization (IVF) cycles and of follicle-stimulating hormone(FSH)/hMG/hCG-stimulated IVF cycles were compared. In seventy three cycles stimulated with CC/hMG/hCG regimen, follicles were aspirated during exploratory laparotomy and yielded 7 pregnancies, and in 83 cycles stimulated with FSH/hMG/hCG regimen, follicles were aspirated by laparoscope and made 13 pregnancies. Serum estradiol($E_2$) and progesterone($P_4$) levels were determined on days 2, 5, 7, and 9 after follicle aspiration. The FSH/hMG/hCG regimen was more effective than the CC/hMG/hCG regimen in folliculogenesis, ie, ovarian stimulation, follicular phase $E_2$ peak levels, oocyte maturation, and the number of retrieved oocytes. There was no significant difference between luteal serum $P_4/E_2$ ratio of the two regimens, suggesting that secretory endometrial build-up ability for implantation may not differ each other. Several significant correlations were observed between follicular phase seum $E_2$ peak levels and luteal phase serum $E_2$ and $P_4$ levels in the FSH/hMG/hCG-stimulated cycles but any correlation was not significant in the CC/hMG/hCG-stimulated cycles, suggesting that somewhat more follicles may eventually fall in atresia even after attaining dominant stage in the CC/hMG/hCG-stimulated cycles than the FSH/hMG/hCG-stimulated cycles.

• Clinical and Experimental Reproductive Medicine
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• 제42권2호
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• pp.62-66
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• 2015

Objective: To evaluate the effect of a gonadotropin-releasing hormone (GnRH) antagonist protocol using corifollitropin alfa in women undergoing assisted reproduction. Methods: Six hundred and eighty-six in vitro fertilization-embryo transfer (IVF)/ intracytoplasmic sperm injection (ICSI) cycles were analyzed. In 113 cycles, folliculogenesis was induced with corifollitropin alfa and recombinant follicle stimulating hormone (rFSH), and premature luteinizing hormone (LH) surges were prevented with a GnRH antagonist. In the control group (573 cycles), premature LH surges were prevented with GnRH agonist injection from the midluteal phase of the preceding cycle, and ovarian stimulation was started with rFSH. The treatment duration, quality of oocytes and embryos, number of embryo transfer (ET) cancelled cycles, risk of ovarian hyperstimulation syndrome (OHSS), and the chemical pregnancy rate were evaluated in the two ovarian stimulation protocols. Results: There were no significant differences in age and infertility factors between treatment groups. The treatment duration was shorter in the corifollitropin alfa group than in the control group. Although not statistically significant, the mean numbers of matured (86.8% vs. 85.1%) and fertilized oocytes (84.2% vs. 83.1%), good embryos (62.4% vs. 60.3%), and chemical pregnancy rates (47.2% vs. 46.8%) were slightly higher in the corifollitropin alfa group than in the control group. In contrast, rates of ET cancelled cycles and the OHSS risk were slightly lower in the corifollitropin alfa group (6.2% and 2.7%) than in the control group (8.2% and 3.5%), although these differences were also not statistically significant. Conclusion: Although no significant differences were observed, the use of corifollitropin alfa seems to offer some advantages to patients because of its short treatment duration, safety, lower ET cancellation rate and reduced risk of OHSS.

• Clinical and Experimental Reproductive Medicine
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• 제24권1호
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• pp.135-141
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• 1997

The early studies demonstrated that the relative amount of FSH was important for stimulating normal ovarian activity and demonstrated the existence of a threshold level for FSH, above which follicular growth was activated. It was found that only a modest increase in circulating FSH level above the threshold (between 10 and 30%) was required to stimulate folliculogenesis. In addition, FSH is primary responsible for initiating estradiol production through the activation of the aromatase enzyme system in granulosa cells, follicular secretion and growth. LH on the other hand, plays a supportive role in ovarian steroidogenesis, stimulating the ovarian thecal cells to produce androgen, the precursor for estradiol synthesis. But there is now an increasing number of reports in the literature demonstrating an adverse effect of LH on fertility and miscarriage in infertile and fertile women. So HP-FSH is the drug of a highly purified FSH preparation which has a higher specific activity and far fewer impurities than FSH. This study was performed to evaluate the efficacy and safety of HP-FSH administered (SC; subcutaneous) versus FSH(IM; intramuscular) for ovulation induction. 20 candidates patients for ovulation induction were participated. All patients underwent pituitary desensitizing with a long gonadotropin-releasing hormone (GnRH) agonist protocol and ovulation induction was started with HP-FSH SC (10 patients; group I) or FSH IM (10 patients; group II). After ovulation, outcome of ovulation induction and local reaction of injection site were compared. There were no difference of outcome of ovulation in two groups except pregnancy rate/embryo transfer. Group I had a higher pregnancy rate/ embryo transfer than Group II (44.4% Vs 28.6%). Pain, redness, tenderness, bruising and itching when the injection received on the first 5 days of treated (50 SC and 50 IM injections) were assessed. There were no significant difference (P>0.05) in the incidence of tenderness, bruising and itching between the IM and SC injection. But IM injection (FSH) had a tendency of higher above incidence. The number of reports of pain, redness were significantly increased in IM injection group (P<0.05). These results indicate that SC administration of HP-FSH has been shown to be as effect for superovulation as traditional gonadotropins, with an improved safety profile due to the removal of extaneous proteins.

• Archives of Pharmacal Research
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• 제25권3호
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• pp.357-363
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• 2002

The effect of a new rhFSH, PG-0801, on oocyte quality, ovulation and in vitro fertilization (IVF) was examined in androgen-sterilized mice. Experimental sterility was induced by a single subcutaneous injection of testosterone propionate (TP, 1 mg/head) into 5 day old female mice. Ovulation was generated in the 10 to 13-week old TP-injected mice by a subcutaneous rhFSH injection (1, 5 or 10 IU/head) followed 48 hours later by a second rhFSH injection (1, 5 or 10 IU/head). For comparison, a subcutaneous PMSG (5 IU/head) injection was used for folliculogenesis and a hCG (5 IU/head) injection was used for ovulation. These were administered using the same protocol. The eggs were harvested from the oviducts and counted 17 to 20 hours after the second injection. IVF was performed by adding sperms ($2{\times}10^{5}/ml{\;}to{\;}2{\times}10^{6}/ml$) to determine the functional activity of the eggs, and the fertilization rate was measured. In addition, the pregnancy rate and fetal development were examined after 15-17 days of gestation. The number of oocytes recovered from the rhFSH/rhFSH group increased dose-dependently and was slightly higher than that of the PMSG/hCG group. The pregnancy rates of the group receiving 1, 5, and 10 IU of rhFSH/rhFSH were 50%, 66.7%, and 75%, respectively, which were significantly higher than that of the control (untreated) group (0%). The numbers of viable fetuses in the 1, 5, and 10 IU/head of the rhFSH/rhFSH group ($8.0{\pm}1.50$, $8.9{\pm}1.02$, and $8.9{\pm}1.12$ fetuses/dam, respectively) were comparable to that of the 5 IU/head PMSG/hCG group ($9.4{\pm}0.94$). The mice receiving rhFSH/rhFSH and PMSG/hCG showed similar fertilization rates (around 65%) via the IVF procedure. These results demonstrate that a new rhFSH, PG-0801, may be useful for inducing ovulation in functionally infertile patients and for superovulation in ovulatory patients participating in assisted reproductive technology (ART) programs.

• 한국발생생물학회지:발생과생식
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• 제7권2호
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• pp.119-126
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• 2003

본 연구실에서는 이전의 실험에서 suppression subtractive hybridization(SSH)을 통하여 생쥐의 생후 1일자 난소와 5일자 난소에서 차이 나게 발현하는 유전자들의 목록을 얻었고 그 중에서 MT transposon-like element, clone MTi7(MTi7)이 성장하는 난포에서 더 높게 발현한다는 것을 알아냈다(Park et al., 2002). In situ hybridization과 RNA interference를 이용한 연구결과, MTi7은 난자에서 특이 적으로 발현하는 유전자로 특히 난자성숙에 관여하는 것으로 관찰되었다(Park et at., 2003). 그러나 현재까지 MTi7의 염기서열은 생쥐에서만 알려져 있다. 따라서 본 연구는 두 부분으로 나누어서 첫째, MTi7이 다른 포유류에도 존재하는지 알아보기 위해 소,돼지, 흰쥐 그리고 사람 등 각기 다른 네 종의 난소 cDNA를 사용하여 새로운 MTi7을 분리하고자 하였으며, 둘째, 생쥐의 MTi7이 transposon의 특징을 갖고 있어 다른 유전자에 삽입되어 있는지를 알아보기 위해 inverse PCR을 시행하여 MTi7주변의 유전자가 있는지를 조사하였다. 네 종의 난소 cDNA를 사용하여 생쥐의 MTi7과 매우 유사한 염기서열을 갖고 있음을 알았다(87%∼98%). Inverse PCR 결과, 생쥐의 MTi7은 beta-carotene 15, 15'-monooxygenase(Bcdo) 유전자 혹은 serine protease inhibitor, Kunitz type I(Spint 1) 유전자에 삽입되어 있음을 알 수 있었다. 본 연구의 결과로 여러 포유류의 MTi7 sequence를 알아내고, 또한 생쥐의 MTi7이 삽입되어 있는 유전자를 알아냄으로써 머지 않은 장래에 난자형성 및 난포형성과정에 있어서 MTi7의 역할을 밝혀 낼 수 있을 것으로 기대된다.